Iowa City, IA
Carol Scott-Conner, MD, a nationally known breast surgeon with University of Iowa Health Care, shares her unexpected encounter with a heart rhythm disturbance in her own words.
Over the years I’ve taken care of many women. Women are acutely aware of their risk of breast cancer. Most women know they need to go for mammograms and have regular breast exams.
But most don’t realize that far more women die every year from heart disease and stroke than from breast cancer. They don’t know their own risk, and they don’t know how to recognize the signs of a heart problem.
I know, because it happened to me.
In 2007, I felt my heart flutter a little after a long stretch of night call. I’d been running on adrenalin and caffeine, as surgeons do, and I thought nothing of it. After all, I was a healthy woman, I was at my ideal weight, I had normal cholesterol, and I exercised most days.
I ignored it until things got so bad I was having trouble breathing at night. Then I went to Rebecca Davis, MD, an internal medicine specialist at UI Hospitals and Clinics. She told me I had atrial fibrillation.
I’d learned about atrial fibrillation in medical school. In atrial fibrillation, the heart beats fast and irregularly. The upper chambers of the heart, the atria, quiver instead of pumping blood into the lower chambers, or ventricles, so blood puddles in the nooks and crannies of the atria. That stagnant blood can form clots. Atrial fibrillation is a common cause of stroke—when one of those clots breaks free and travels to the brain.
I knew all of these things. What I didn’t know about atrial fibrillation, even though I’m a doctor, was that it becomes more common the older you get. I didn’t know you could get atrial fibrillation without having some known problem with your heart—a heart valve problem or a heart attack, for example.
I didn’t know that I was at risk. And I didn’t know that the longer you have atrial fibrillation, the harder it is to treat. It is as if the heart settles into the new rhythm and forgets the old. Because of my ignorance, my heart had been beating fast and irregularly for long enough that it couldn’t pump well any more.
I was hospitalized at UI Hospitals and Clinics and treated by Dr. James Martins, a UI Heart and Vascular Center cardiologist. I was cardioverted (a medical procedure using electricity or medications to convert an abnormal heart rate or arrhythmia to a normal rhythm) twice during that first week. Over the following months, his treatment was thoughtful, compassionate, and nuanced. He carefully and repeatedly adjusted the medications until we found a combination that worked.
In time, I was able to come off the heart pills. I learned better ways to manage the stress of my job. Dr. Davis and I monitor my blood pressure and now the only pill I take is a blood pressure medication. I’ve gone four years now without a relapse.
As a cancer surgeon, I know the treatment of breast cancer requires a multidisciplinary approach best delivered in a comprehensive cancer center like ours. The treatment of patients with heart and vascular problems is no different—it also requires an experienced team.
As a cancer surgeon, I realize the need to educate women about their risk of cancer and how to manage that risk.
As a former heart patient, I now recognize the need to teach women about their risk of heart disease and how to manage that risk and recognize the symptoms when they occur.
So when I talk to my patients about risk reduction, I also discuss heart health. I tell them that the good news is that diet, exercise, and smoking cessation—all things that are good for heart health—are also good for breast health.
But because of my own experience, I know that we also need to teach women about the signs and symptoms of heart disease. About what to do when they feel any of those symptoms. And about the importance of seeking care.
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